Payer: Page 179
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Zoom+ bucks system with targeted health plan
The company is going after millennials with a one-stop shop strategy.
By Heather Caspi • May 11, 2016 -
Montgomery County Planning Commission
Aetna not exiting ACA exchanges, could expand market presence
The insurer noted it won't finalize its ACA market plans until September.
By Jeff Byers • May 11, 2016 -
Clinton campaign revives push for public option
Clinton on the campaign trail this week discussed letting younger individuals buy into Medicare.
By Heather Caspi • May 11, 2016 -
Slavitt: MACRA won't hinder solo, small practices
Stakeholders have until June 27 to submit MACRA implementation feedback to CMS.
By Ana Mulero • May 11, 2016 -
More than 40 patient groups criticize CMS' proposed Part B model
The groups raised concerns about CMS' proposed use of comparative effectiveness research and cost effectiveness.
By Nina Flanagan • May 10, 2016 -
Deep Dive
U.S. inches closer to national single-payer plan conversation
With more than 2,200 physicians supporting a single-payer proposal last week, are we ready to seriously discuss the possibility of a single-payer program?
By Julie Henry • May 10, 2016 -
New CMS regs allow struggling ACA co-ops to appeal to private investors
In addition, the agency amended requirements for the organizations' directors.
By Heather Caspi • May 9, 2016 -
Cigna questions whether Anthem merger will close in 2016
The deal could be in jeopardy as Cigna noted Anthem could owe a breakup fee of $1.85 billion if the deal isn’t finalized by Jan. 31, 2017.
By Heather Caspi • May 9, 2016 -
ACA bronze plans could be at risk after proving least profitable
Experts disagree whether the insurers will phase out the plans and further destabilize the marketplace.
By Heather Caspi • May 9, 2016 -
CMS releases new Medicare data in bid to increase transparency
The 2014 dataset includes information for more than 986,000 physicians who received a total of $91 billion in Medicare payments.
By Meg Bryant • May 6, 2016 -
2,000 doctors endorse single-payer healthcare reform proposal
New taxes to fund a single-payer system would be offset by reduced premiums and out-of-pocket spending, under a proposal in the American Journal of Public Health.
By Meg Bryant • May 6, 2016 -
California fines Anthem $415K over grievance violations
Opponents of the ending Cigna merger have pointed toward Anthem's historic issues with the grievance process as a reason to halt the deal.
By Heather Caspi • May 5, 2016 -
Opioid epidemic costs shifting to insurers
CDC analysis found consumer out-of-pocket spending on opioids per 100 morphine milligram equivalents dropped from $4.40 to $0.90.
By Heather Caspi • May 5, 2016 -
Deep Dive
Performance measures put heat on hospitals
Stakeholders react to the abundance of federal performance measures. Some say doctors just want more time to take care of their patients.
By Meg Bryant • May 5, 2016 -
Tenet posts $59M Q1 loss as lawsuit reserve grows to $407M
The company predicts competition will take on UnitedHealth's deserted ACA markets and stated it will be happy to fight for it.
By Meg Bryant • May 4, 2016 -
Low costs land 231 hospitals a Medicare bonus — despite low quality
CMS said it may revise regulations so hospitals rated below the national quality average won’t receive a bonus in the future.
By Meg Bryant • May 4, 2016 -
Illinois Blues nixes credit card payments for individual policyholders
The payer is looking for ways to reduce administrative costs without impacting the quality of care.
By Meg Bryant • May 4, 2016 -
Newly expanded Medicaid program dubbed 'Healthy Louisiana'
The rebranding will play into promotional efforts throughout the state.
By Heather Caspi • May 4, 2016 -
Tenet predicts competition will take UnitedHealth's ACA business
When UnitedHealth moves out in 2017, others will be happy to replace it, Tenet says.
By Heather Caspi • May 4, 2016 -
Humana to exit Virginia, Alabama ACA markets
The move will leave Blue Cross and Blue Shield of Alabama as the only choice in the state's ACA market.
By Jeff Byers • May 4, 2016 -
Deep Dive
Breakdown of the MACRA Proposed Final Rule
As with most proposed rules, initial feedback has been mixed.
By Julie Henry • May 4, 2016 -
Moda makes good on raising $115M to strengthen plan after state takeover
The company is getting back on financial track, though with fewer customers.
By Heather Caspi • May 3, 2016 -
UPMC, Jameson Health finalize merger, $75M facilities investment
Jameson, a rural hospital with 1,200 employees, had been looking to partner with a larger health system for years as its patient revenue has been dropping.
By Nina Flanagan • May 3, 2016 -
CMS takes feedback for finalized Quality Measure Development Plan
The plan provides a quality measure development framework that will be used to support MIPS and advanced alternative payment models.
By Heather Caspi • May 3, 2016 -
Deep Dive
Industry offers mixed reactions to the Medicaid 'uber rule'
The finalized medical loss ratio at 85% has its share of supporters and opponents.
By Julie Henry • May 2, 2016
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